Coronavirus spread: Govt's U-turn on 'limited community transmission'

Health ministry says it's still local transmission; use of the term on its website on Sunday was to highlight government's 'action on field'

A day after a health ministry document mentioned “limited community transmission” of the Covid-19 pandemic in the country, the government asserted on Monday it had reached only a “local transmission” stage.
 

Offering little explanation of why the phrase “limited community transmission” was used in a standard operating procedure (SoP) document to transport a Covid-19 positive patient, health ministry’s Joint Secretary Luv Aggarwal reiterated it was only local transmission. The term used in the website of the ministry was only to highlight the government’s “action on the field”, he said, without elaborating.
 

“We would be the first ones to get back to you to explain that, yes, there is community transmission in the country if need be,” he said.
 

The government did not clarify if there was any intermediate stage between local and community transmission. A public health expert, however, said on grounds of anonymity that chances were high that community transmission had started in India.
 

“In fact, community transmission has started in all the countries where Covid-19 has affected the population,” the expert said. 

The expert clarified that there was “no intermediate stage between local and community transmission”.
 

Stage one of the pandemic is when cases are imported from affected countries and people with travel history test positive for the disease. In stage two, local transmission begins when the source can be traced. So, people who have come in contact with someone with travel history or any Covid-19 positive case also test positive.
 

In the third stage, called community transmission, the source of infection cannot be traced and, hence, it becomes difficult to isolate such cases. In the fourth stage, there are several clusters of the disease in a country and the spread becomes uncontrollable.

The health expert said while stage three was inevitable, it can be delayed. “How we control the spread of the disease in stage two and three, that is if we can plateau the spread, the fourth stage can be avoided,” the expert said.

Last week, a tweet by Delhi Chief Minister Arvind Kejriwal about receiving a report from a panel of doctors who recommended measures to prepare for a potential stage three outbreak in Delhi had also hinted that the danger was still alive and not very far.

Aggarwal said that of the cases that had come up till Monday evening (1,071), the number of cases where the authorities were doing contact tracing so as to identify where they got the infection from was very limited or miniscule, without specifying the exact numbers.
 

He cautioned against “going into the semantics” in context of the word “community” and, on a lighter vein, even said it would be dropped from future communication. His responses on other indicators of a wider spread of infections, i.e. the hotspots, were rather guarded. Hotspots are areas with more number of cases or limited cases but in a densely populated area.

“As part of that strategy we identify the containment zone as well as the buffer zone still around it and we form special teams, the district administration coordinates the efforts,” he said.

Aggarwal cited some numbers trying to show how the spread of the disease has been arrested through a lockdown —  while it took India12 days to reach from the 100th to the 1,000th case, the same number of days saw other, more developed and less populated countries, reporting anywhere between 3,500 and 9,000 cases. However, the relatively low number of cases can also be attributed to fewer tests in India.
 

Numbers aside, the massive exodus of migrant labourers to their native places last week also left the possibility of rapid transition alive.
 

Meanwhile, India is using this period to build treatment infrastructure on war footing. Experts have said that after the lockdown, India would need to engage in massive testing to ensure the spread is under control.